On April 28th, 2009 Social Medicine Rounds hosted four New York City food activists in a session entitled: “Feast or Famine: Building an Oasis in the Food Desert.” This rounds was arranged by Drs. Victoria Mayer and Vanessa Pratomo and is part of a larger series organized by the Public Health Association of New York City (PHANYC). [See our previous posting: Feast and Famine: Obesity, Diabetes and Hunger in New York City.]
Joel Berg, Triada Stampas, Debi Lomax, Zena Nelson, Drs. Mayer & Pratomo
As clinicians we daily see patients whose health is deeply affected by nutrition. Counseling patients on diet often seems a frustrating affair and there is scant evidence that it does much good. We were interested in a better understanding the politics of food and in learning about what local food activists were up to. Our invited panel included Joel Berg of the NYC Coalition Against Hunger, Debi Lomax of the Bronx District Public Health Office, Zena Nelson of the South Bronx Food Coop, and Triada Stampas from the Food Bank for New York City.
The paradoxical link between food insecurity and obesity
Joel Berg is the Executive Director of the New York City Coalition Against Hunger and author of the recently published All You Can Eat: How Hungry is America. He began by emphasizing the lack of nutrition education in medical schools, arguing that nutrition should be the centerpiece of public health. He saw hunger and obesity not as separate problems but rather as “flip sides of the malnutrition coin.” He pointed out that currently 25 million Americans (about 8% of the population) use food pantries and soup kitchens. Here in New York City an estimated 1.3 million people (about 16% of the 8.2 million New Yorkers) are living in food insecure homes. The poor are often accused of not knowing how to budget, shop and cook. But Mr. Berg pointed out that working class people often don’t have access to affordable, good food, a point reiterated by the other three speakers Faced with limited cash, people often choose unhealthier foods because their high fat content. Time constraints – due to work schedules – further limit the ability of working class families to shop and cook.
Mr. Berg argued that good nutrition is a three legged stool based on affordability, proximity and education. The way to make good food more affordable was the increase wages, expand access to WIC and encourage our kids to take advantage of food offered in the schools (breakfasts, lunch, afterschool meals and summer breakfasts). Making sure that school food is healthy is also an area of intense activism. While New York City has recently banned the sale of soda in the schools, highly sugared drinks like Snapple continue to be sold.
Farmers’ Markets in the Bronx
Debbie Lomax, a Program Officer for the South Bronx District Public Health Office of NYC Department of Health, then discussed the DOH Farmers’ Market Program. Quoting their program booklet: “The Farmers’ Market Program encourages fruit and vegetable consumption by promoting farmers’ markets in the South Bronx. There are currently 11 markets in the area. The DPHO publicizes these markets to community residents and health care providers, by giving out “Health Bucks” – $2.00 vouchers redeemable at farmers’ markets for the purchase of fruits and vegetables.”
A complete description of this program and a list of current Farmers’ Markets can be downloaded from this link. More information on Healthy Bucks can be found at this link.
A Food Coop grows in the Bronx
Zeena Nelson is one of the founders of the South Bronx Food Coop. Her interest in food was sparked by her personal difficulties finding good food in her South Bronx community. She had studied business at Fordham University but was unenthusiastic about working for corporate America. She was pushed into food activism when a friend died of complications of massive obesity. What, she wondered, were the economics behind the fact that certain neighborhoods don’t have good food available? She obtained a $20,000 starter grant from Merill-Lynch to set up a small food coop. The coop now has 155 members and operates a small store on Third Avenue Members of the cooperative are a diverse group about ½ of whom are from the South Bronx. The cooperative provides a variety of services including cooking and yoga classes. The Cooperative has plans to create a commercial hydroponic farm inside of a local building.
[For a fascinating look at the world of urban agriculture in New York City, visit Kerry Trueman's Retrovore.com.]
… as do the soup kitchens
Finally, Triada Stampas shared her work at the Food Bank for New York City. The Food Bank started 26 years ago in a big warehouse located in the Hunts Point food market in the South Bronx. The Bank initially supplied food to a handful of sites providing “emergency food.’ Sadly, it currently supplies some 1200 soup kitchens and pantries (yes, that’s 1200 sites) located throughout the City. . Ms. Stampas noted that such a network simply was not needed in the 1970′s.
The food at the bank comes from various sources. The government – federal, state and city – provides some. Feeding America, a national umbrella for food banks, provides food largely donated by corporations. The bank itself raises funds to purchase food. The Bank also conducts research on who uses emergency food. By their estimates there are 4 million New Yorkers (nearly half the population) who have difficulty accessing affordable food. Ms. Stampas noted that the term “emergency food” was really a misnomer. For many people emergency food represented subsistence food. She pointed out, for example, that 80% of families receiving food stamps run out of food before the month is over. She spoke about understanding nutrition as a function of the “food environment.” Bronx residents, according to a recent study by the Marist Institute, have the greatest difficulty finding affordable food in the city.
Ms. Stampas had some specific suggestions for clinicians. She stressed that it was important to talk with patients about what they eat, where they shop for food, and how they afford the food they buy. She pointed us to a food bank locator on the web that could be used when our patients needed food. She signalled the importance of political advocacy to improve food stamp benefits and increase the Earned Income Tax Credit.
Clinicians as advocates
During the question and answer period a number of an additional areas for activism were suggested. Hospitals need to promote healthy eating for staff, patients and visitors. Political support is needed right now for the school meals program and WIC both of which are up for authorization in Congress. In New York State a Healthy Schools Law is being considered in Albany. The speakers highlighted the importance of physician voices in support of these programs.
Posted by Matt Anderson, MD
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